Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what flexibility (a) NICE and (b) NHS England have to approve for use drugs that (i) are used in combination with other drugs, (ii) are used for various (A) conditions and (B) lines of treatment and (iii) provide significant benefits for some but not all patients; and what tools those organisations use to ensure the effectiveness of such appraisals.

The National Institute for Health and Care Excellence (NICE) makes recommendations for the National Health Service on whether new licensed medicines, and significant licence extensions for existing medicines, should be routinely funded by the NHS. The NICE is able to recommend most new medicines for use by the NHS, including as a result of commercial agreements negotiated between NHS England and the company, in line with the commercial framework for new medicines.

The NICE develops its guidance in line with its published health technology evaluations manual, which sets out the circumstances in which its Appraisal Committees are able to apply flexibility in the evaluation of specific treatments. The NICE is, for example, able to apply a modifier in the evaluation of medicines for severe diseases that means that its committees are able to recommend medicines at a higher cost-effectiveness threshold than for less severe diseases. The NICE appraises combination therapies using the same methods that it uses for appraising single drug therapies.